Basic Information
| Provider Information | |||||||||
| NPI: | 1609095017 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KUO | ||||||||
| FirstName: | CINDY | ||||||||
| MiddleName: | YUNG-FANG | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1150 EXPRESS CIR | ||||||||
| Address2: | |||||||||
| City: | COLTON | ||||||||
| State: | CA | ||||||||
| PostalCode: | 923246229 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6262267424 | ||||||||
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| Practice Location | |||||||||
| Address1: | 111 N SEPULVEDA BLVD | ||||||||
| Address2: | |||||||||
| City: | MANHATTAN BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902666861 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3103792134 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/24/2007 | ||||||||
| LastUpdateDate: | 11/30/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 11/30/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 20A8907 | CA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.